Диагностическая ценность предоперационной биопсии в дифференциальной диагностике эпителиальных образований толстой кишки

Abstract

Objective. Preoperative biopsy before endoscopic resection of epithelial colorectal tumors is recommended. Some papers show variance between biopsy results and total morphological examination. The aim of the study was to evaluate sensitivity, specificity and diagnostic accuracy of routine preoperative biopsy and also positive and negative predictive value. Methods. 86 patients with 101 epithelial colorectal tumors were included. Biopsy was taken from any tumors before endoscopic resection. The results of morphological examination for biopsy specimens and resected tumors have been analyzed and compared Results. The average polyp size was 2,3 сm. Total match was in 43 cases (42.6 %). In 17.8 % of cases dysplasia grade was misdiagnosed, in 88 % was underestimated by biopsy. 27 % of tumors were misdiagnosed serrated adenomas. 14 tumors were adenocarcinomas, misdiagnosed by biopsy. Sensitivity, specificity and diagnostic accuracy for serrated adenomas diagnosis was 30, 98.3, and 71.2 %; for dysplasia staging - 70.3, 95.7, and 82,1 %; for early cancer diagnosis - 16.6, 100, and 85,1 % respectively. Conclusions. The data shows that preoperative biopsy has a low level of sensitivity, specificity and diagnostic accuracy for some cases.